痘疹害眼。多因胎毒。或前或后。积热蕴深。或余毒攻侵。自脏达外。致成星翳膜朦。宜分虚实。但以活血
解毒而已。活血不致于热。解毒不致于凉。俟靥后治之。虽有目翳。切不可用点药。只宜活血解毒。俟五
脏平和。翳当自去。若误点药。则非徒无益。而反害之。即用丸散。须小剂调服。如眼无光。过百日后血气
完复。则目自明矣。海藏云。东垣先生治 后风热毒。翳膜气障遮睛。以泻青丸治之。大效。初觉易治。保
命集云。非 后翳膜。亦能治之。泻青丸减大黄一半用之。
浊害清和。重轻非一。有病于前。有病于末。有久闭而不开。有肿痛而赤烂。有积热而内症昏蒙。或乘虚而
冲风泪湿。有阴邪结星而为翳。有阳邪烁膏而成疾。当因症而详源。毋偏泥而拗执。
此症专指痘疹以致目疾之谓。夫痘疹为毒最重。自禀受以来。蕴积恶毒深久之故。若痘疹发。则诸经
百脉清纯太和之气。皆被搅扰。正气大虚。则邪乘虚而入。各因其犯而为病。目窍于肝胆。肝胆乃清净
之府。邪正理不并立。今受浊邪熏灼。失发生长养之源。故病亦易侵。皆由乎人不能救。而且害之之故
也。或于病中食物发之太过。怀藏大暖。误投热药。多食甘酸而致病者。或于病后之虚弱未复。恣食辛
辣燥腻。竭视劳瞻。炙衣烘火。冲冒风沙烟障而致病者。有为昏蒙流泪。成内障者。有为赤烂星障。成外
症者。有余邪蕴积蒸燥。肝胆热郁之极。清气受伤。延及瞳神。而成凝脂黄膜花翳蟹睛等症之重而目
HT凸者。有余邪流为赤丝羞明微星薄翳等症之轻而病自消者。轻重深浅。各随人之所受。所患亦不
一。业斯道者。宜致思明辨。以免不用刃而杀人。取罪冥冥。祸延子孙之报。当细验其症。审其经而投治
之。不可执泥概治。恐有激变之祸。盖痘疹之后。正气虚而血脉伤。邪得易乘。非常人可比。大凡痘症目
疾。惟瞳神未损。亦有可治之理。但宜早治。则易退而无变乱之患。迟则气血凝定。虽无变乱。其退亦甚
迟矣。宜服∶
谷精草汤
谷精草（六分） 白芍 荆芥穗 玄参 牛蒡子 连翘 草决明 菊花 龙胆草（各五分） 桔梗（三分）
上锉剂。白水二钟。灯心十段。煎至六分。去滓。不拘时服。
退翳散（治内外翳障。或疮疹后余毒不散。）
真蛤粉（另研） 谷精草（生研为末各一两）
上研匀。每服二钱。用猪肝三指大一片。批开。掺药在上卷定。再用麻线扎之。浓米泔水一碗。煮肝熟为
度。取出放冷。食后临睡细嚼。却用原汁送下。忌一切毒物。如斋素用白柿同煎。令干。去药食柿。
（孙盈重云。凡痘疮不可食鸡鸭子。必生翳膜。钱季华之女年数岁。痘疮后两目皆生翳。只服此药。各退
白膜三重。瞳子方了然也。）
望月丸（治痘入眼。致生翳膜。）
望月砂（四两焙干） 石决明（醋 ） 防风 白芍 谷精草 草决明 木贼（各一两） 当归（五钱）
上共为细末。炼蜜为丸。小儿量其大小。或用一钱。或五分一丸。荆芥汤化下。
疏风汤（治痘后患眼。其珠不红。眼皮弦生一小颗。数日有脓。俗谓狗翳。发后又发。甚
至眼毛上发一白泡。服此。）
荆芥穗 蝉蜕 桔梗 归尾 甘草梢（各五分） 防风 白芷（各四分） 石膏（ 一钱二分）
白芍药（七分） 茯苓 连翘 苍术（泔水制各六分）
共为剂。葱白一段。大米一撮。白水二钟。煎至七分。去滓。食后热服。
通窍散（治痘后眼生星翳）
辰砂（三钱） 珍珠 琥珀（各二钱） 麝香（一钱） 玛瑙（一钱五分） 冰片（五分）
上研如细粉。若翳在右目。吹左耳。翳在左目。吹右耳。若两目有翳。即吹两耳。盖以吹耳能通心肺二窍之故也。
胎兔丸（治小儿痘后余毒。攻致一目或两目。黑珠凸出。翳膜瞒睛。红赤肿痛。眵泪交作。服此获效。）
胎兔（去毛洗净用阴阳瓦焙干为末每用一两二钱） 蔓荆子（去膜晒干为末） 菊花（去梗叶晒干为末各加一两）
上末共为一处。炼真川蜜为丸。量孩童大小。不拘钱分。俱白滚汤化下。
愚按兔、礼记谓之明视。言其目不瞬而了然也。且得金气之全。性寒而解胎中热毒。能泻肝热。盖肝开
窍于目。热甚则昏蒙生翳。热极则珠胀突出。今痘后生翳。睛珠凸出者。皆胎毒盛极之所致也。方用胎
兔为君者。取二兽之精血所成。可以解胎毒也。草木之性。难以取效。故借血气之属耳。臣以蔓荆微寒。
取其能凉诸经之血。且能搜治肝风。及太阳头疼。目痛目赤泪出。利九窍而明目。性又轻浮。上行而散。
更佐之以菊花者。取菊得金水之精英。补益金水二脏也。夫补水可以制火。益金可以平木。木平则风
自息。火降则热自除。其药虽简。用意最深。是方于婴儿也。安有不愈者乎。
（此方乃广陵甘棠镇王海明子。痘后睛HT 突出。偶一客见之。告曰。此目有一药可治。但不知能
得否。询之。乃胎兔也。其父遍觅得之。按方炮制。药尽而目收。余推幼幼之心。故广其传。）
凡痘后近视略言小儿受胎毒。感风寒而发痘疹。痘发则正气虚。邪气乘虚而入。调理失宜。则胎为害。
邪气入于肝胆二经。兼真元未复。故发目疾。盖目窍于肝。专仗肾水。经云。目得血而能视。肝藏血。邪热
余毒。蒸灼肝经。肝属木。木被火克。而灼损胆汁。又肾属肝之母。肝被火克而胆汁涸。以致障生。神光不
清。水不能滋其子也。经云。不能远视者。责其有火是也。日渐深者。嗜欲日开。食物过辛。真元日不足耳。
治法宜先清解肝经积热之毒。次补真元。水升而火自降。火降而邪气自除。目自明矣。
清解散（早服）
谷精草（一两） 石决明（ 八钱） 白菊花（去蒂酒洗七钱） 绿豆壳（六钱）
共为细末。每服二钱。用大陈柿饼一个。去蒂核。米泔水钟半。煎半干。空心食柿饼。原汁汤并服。
补元散（晚服）
夜明砂（淘净一两为末） 真蛤粉（五钱为末）
上共研为细末。每服二钱。用公猪肝一大片。将肝披开。搽药在内。米泔水煮熟。任意食之。以原汁汤嚼
下。每日早晚服。过一七。再服。
加味地黄丸
怀生地（竹刀切片酒洗焙干四两） 山萸肉（酒洗焙） 山药 白茯苓（各二两） 泽泻 牡丹皮（各两半）
菊花（去梗叶） 麦冬肉（焙干） 当归（焙各一两） 五味子（五钱）
上共为细末。炼蜜为丸。空心淡盐汤化下。量小儿大小为丸。如少年火旺。加黄柏、知母各五钱。俱用盐
水制。如目生翳。服前药不退。可用点药。
退云散
红珊瑚 珍珠 辰砂 硼砂（各等分）
俱生用。共研极细无声。每日点二次。
接痘后余毒。则必见云翳遮睛外障等症者多。如两目清白。外无翳障。止艰于视者。皆禀受天真虚弱。
肝肾二经不足。故神光淡白色。瞳神或开大。不必用点丹。不必服退翳等药。但服固本之剂。则精生气。
气生神。非独益于目。更能绵延寿算。
固本丸
熟地黄 生地 菟丝子（各一两） 当归 五味子 枸杞（各八钱） 麦门冬（去心）
牛膝 天门冬（各七钱） 茯神 地骨皮（各五钱） 远志（四钱）
以上各味。俱要法制。秤足分两。共为细末。炼蜜为丸。如桐子大。每服二三十丸。空心淡盐汤送下。晚服。
茶酒任意送下。可以久服。
按设前后之二论并方。谓眼珠清白而无翳障。不知瞳子既有淡白色。既非外之障翳。乃内之障气也。
但气翳二字。要辨明白。宜主孰治。不可错治。庶不误终身之患矣。
Ocular diseases caused by smallpox and measles are mostly due to fetal toxins. Whether before or after the eruption, accumulated heat may be deeply entrenched, or residual toxins may attack and invade from the internal organs to the exterior, resulting in astigmatism, corneal opacities, and membrane obscuration (corneal clouding and white membranes blocking vision). Treatment should distinguish between deficiency and excess, but the basic principle is merely to invigorate blood and resolve toxins. Invigorating blood should not generate heat, and resolving toxins should not be overly cooling. Treatment should wait until after the scabs fall off. Even if there are ocular opacities, eye drops must absolutely not be used; only internal administration of blood-invigorating and toxin-resolving agents is suitable. Wait for the five zang organs to harmonize, and the opacities will naturally disappear. If eye drops are mistakenly used, it will not only be ineffective but also harmful. Even if pills or powders are used, they must be taken in small doses. If blindness occurs, after one hundred days when qi and blood have fully recovered, vision will naturally become clear. Haizang stated: Mr. Dongyuan treated wind-heat toxins after smallpox, which caused opacities and qi barriers blocking vision, using Xieqing Wan (Drain the Green Pill), with great efficacy. It is easy to treat at the initial stage. *Baoming Ji* (Collection for Preserving Life) also states that non-smallpox-induced opacities can also be treated with this method. Use half the amount of Dahuang (Rhubarb Rhizome) in Xieqing Wan.
Turbid pathogens invading the clear orifices present with varying severity. Some manifest early, some late; some remain closed for a long time without opening, some are swollen, painful, red, and ulcerated; some have accumulated heat causing internal symptoms of dizziness and confusion; some take advantage of deficiency to cause wind-sensitive tearing; some yin pathogens condense into star-shaped opacities; some yang pathogens scorch the cornea leading to disease. One should trace the source in detail according to symptoms, without being biased or stubborn.
This condition specifically refers to eye diseases caused by smallpox and measles. The toxins of smallpox and measles are the heaviest; since conception, evil toxins have been deeply accumulated over a long period. When the rash erupts, the pure and harmonious qi of all meridians and collaterals is disturbed and disrupted. When righteous qi is greatly deficient, pathogens enter taking advantage of the deficiency, causing disease according to their site of invasion. The eyes open to the liver and gallbladder, which are the residences of purity and clarity. Pathogens and righteous qi cannot coexist. Now, suffering from the薰灼 (scorching and steaming) of turbid pathogens, the source of generation, growth, and nourishment is lost, so diseases easily invade. This is all because people fail to rescue and instead harm the patient. Perhaps during illness, food triggers were too excessive, the body was kept too warm, hot medicines were mistakenly administered, or sweet and sour foods were overconsumed, causing disease. Or after illness, while still weak and un-recovered, spicy, dry, and greasy foods were indulged in, eyes were strained by excessive reading or gazing, clothes were heated near fire, or exposure to wind, sand, smoke, and haze occurred, causing disease. Some present as dizziness, confusion, and tearing, forming internal obstructions; some present as redness, ulceration, and star-like barriers, forming external lesions. Residual toxins may accumulate and steam-dry, causing extreme stagnation and heat in the liver and gallbladder, injuring clear qi, extending to the pupil, and forming severe conditions such as purulent membranes, yellow membranes, floral opacities, and crab-eye deformities, even with globe protrusion. There are also mild conditions where residual toxins flow into red filaments, photophobia, micro-stars, and thin opacities, which resolve spontaneously. Severity and depth vary according to individual susceptibility, and the diseases differ. Practitioners should think deeply and discriminate clearly to avoid killing without a blade, incurring guilt in the unseen world, and bringing retribution upon descendants. Symptoms must be carefully examined, meridians assessed, and treatment prescribed accordingly. Do not rigidly apply a uniform treatment, lest you provoke sudden changes. Generally, after smallpox, righteous qi is weak and blood vessels are damaged, making it easier for pathogens to invade; this differs from normal people. In general, for eye diseases caused by smallpox, as long as the pupil is not damaged, there is a possibility of cure. Early treatment is essential for easy resolution without complications; delayed treatment leads to fixed qi and blood stagnation, and although no complications may occur, resolution is very slow. Suitable prescriptions include:
Gu Jing Cao Tang (Valerian Flower Decoction)
Gu Jing Cao (Valerian Flower, 6 fen) Bai Shao (White Peony Root), Jing Jie Sui (Schizonepeta Spike), Xuan Shen (Scrophularia Root), Niu Bang Zi (Arctium Fruit), Lian Qiao (Forsythia Fruit), Cao Jue Ming (Cassia Seed), Ju Hua (Chrysanthemum Flower), Long Dan Cao (Gentian Root) (each 5 fen), Jie Geng (Platycodon Root, 3 fen).
Crush into coarse pieces. Add two zhong of plain water and ten segments of Deng Xin Cao (Juncus Medulla). Decoct until six fen remains. Remove dregs. Take at any time.
Tui Yi San (Remove Opacity Powder) (For internal and external opacities, or residual toxins after rashes that do not dissipate.)
Zhen Ge Fen (True Clam Shell Powder, separately ground) Gu Jing Cao (Valerian Flower, raw ground into powder, each 1 liang).
Grind uniformly. Take 2 qian per dose. Take a piece of pig liver about three fingers wide, slice it open, sprinkle the medicine on it, roll it up, and tie it tightly with hemp thread. Boil in one bowl of thick rice wash water until the liver is cooked. Remove, let cool, chew thoroughly after meals and before sleep, then swallow with the original juice. Avoid all toxic foods. If vegetarian, boil with white persimmons until dry, remove the medicine, and eat the persimmon.
(Sun Yingzhong said: Chicken and duck should not be eaten during smallpox, otherwise opacities will form. Qian Jihua's daughter, aged several years, developed opacities in both eyes after smallpox. She only took this medicine, and three layers of white membranes receded from each eye, allowing the pupils to become clear.)
Wang Yue Wan (Moon-Gazing Pill) (For smallpox affecting the eyes, causing opacities.)
Wang Yue Sha (Cat Feces, four liang, roasted dry), Shi Jue Ming (Abalone Shell, vinegar-treated), Fang Feng (Saposhnikovia Root), Bai Shao (White Peony Root), Gu Jing Cao (Valerian Flower), Cao Jue Ming (Cassia Seed), Mu Zei (Equisetum Ramulum) (each 1 liang), Dang Gui (Angelica Sinensis Root, 5 qian).
Grind into fine powder. Form pills with refined honey. For children, adjust size: use 1 qian or 0.5 qian per pill. Dissolve in Jing Jie Tang (Schizonepeta Decoction).
Shu Feng Tang (Disperse Wind Decoction) (For post-smallpox eye disease, black pupil not red, a small nodule forms on the eyelid margin, suppurates after a few days, commonly called "dog opacity," recurring episodes, or even a white blister on eyelashes. Take this.)
Jing Jie Sui (Schizonepeta Spike), Chan Tui (Cicada Slough), Jie Geng (Platycodon Root), Gui Wei (Angelica Sinensis Tail), Gan Cao Shao (Licorice Tip) (each 5 fen), Fang Feng (Saposhnikovia Root), Bai Zhi (Angelica Dahurica Root) (each 4 fen), Shi Gao (Gypsum Fibrosum, 1 qian 2 fen), Bai Shao Yao (White Peony Root, 7 fen), Fu Ling (Poria), Lian Qiao (Forsythia Fruit), Cang Zhu (Atractylodes Rhizome, processed in rice water, each 6 fen).
Grind into coarse pieces. Add one segment of Cong Bai (Scallion White), a pinch of rice, and two zhong of plain water. Decoct until seven fen remains. Remove dregs. Take hot after meals.
Tong Qiao San (Unblock Orifices Powder) (For post-smallpox astigmatism and corneal opacities)
Chen Sha (Cinnabar, 3 qian), Zhen Zhu (Pearl), Hu Po (Amber) (each 2 qian), She Xiang (Musk, 1 qian), Ma Nao (Agate, 1 qian 5 fen), Bing Pian (Borneol, 5 fen).
Grind into fine powder. If the opacity is in the right eye, blow into the left ear; if in the left eye, blow into the right ear. If both eyes have opacities, blow into both ears. This is because blowing into the ears can unblock the orifices of the heart and lungs.
Tai Tu Wan (Fetal Rabbit Pill) (For pediatric residual toxins after smallpox attacking one or both eyes, causing black pupil protrusion, opacities covering vision, redness, swelling, pain, and copious discharge and tearing. Effective.)
Tai Tu (Fetal Rabbit, hair removed, washed clean, roasted dry on yin-yang kiln, powdered; use 1 liang 2 qian per dose), Man Jing Zi (Vernonia Fruit, membrane removed, sun-dried, powdered), Ju Hua (Chrysanthemum Flower, stems and leaves removed, sun-dried, powdered; add 1 liang each).
Mix powders together. Form pills with true Sichuan honey. Adjust size for children. Dissolve in plain boiling water regardless of weight.
My commentary: Rabbits are called "Ming Shi" (Clear Vision) in the *Book of Rites*, meaning their eyes do not blink and see clearly. They possess complete Metal qi, are cold in nature, resolve fetal heat toxins, and drain liver heat. Since the liver opens into the eyes, severe heat causes confusion and opacities, and extreme heat causes globe protrusion. Post-smallpox opacities with globe protrusion are caused by extreme fetal toxin accumulation. Using Tai Tu as the sovereign drug takes advantage of the essence and blood of two animals to resolve fetal toxins. Plant properties are difficult to achieve such effects, hence animal blood and qi are borrowed. The minister drug is Man Jing Zi, slightly cold, cooling blood in all meridians, searching out and treating liver wind, taiyang headache, eye pain, redness, tearing, benefiting the nine orifices, and brightening eyes. Its nature is light and floating, ascending and dispersing. Chrysanthemum is added as an assistant, possessing the essence of Metal and Water, tonifying the Metal and Water zang organs. Tonifying Water controls Fire; benefiting Metal levels Wood. When Wood is level, wind stops naturally; when Fire descends, heat is eliminated. Though simple, the intent is profound. Applied to infants, how could it not heal?
(This prescription was for Wang Haiming's son in Gandang Town, Guangling, whose globe protruded after smallpox. A guest suggested a remedy, identified as Tai Tu. The father found it, prepared it according to the formula, and upon finishing the medicine, the eye healed. I spread this widely out of compassion for children.)
General remarks on post-smallpox myopia: Children contract fetal toxins and catch wind-cold, triggering smallpox/measles. Eruption depletes righteous qi, allowing pathogens to invade. Improper care allows fetal toxins to cause harm. Pathogens enter the liver and gallbladder meridians, combined with incomplete recovery of primordial yuan, leading to eye disease. The eyes open to the liver, relying entirely on kidney water. The classics state: "The eyes see when nourished by blood." The liver stores blood. Residual heat and toxins steam and scorch the liver meridian. Liver belongs to Wood, which is controlled by Fire, damaging bile. Kidney is the mother of Liver; when Liver is scorched by Fire, bile dries up, causing obstructions, unclear divine light, and failure of Water to nourish its child (Wood). The classics state: "Inability to see far is attributed to Fire." As days pass, desires increase, food becomes too spicy, and primordial yuan daily diminishes. Treatment should first clear and resolve accumulated heat toxins in the liver meridian, then tonify primordial yuan. When Water ascends, Fire descends; when Fire descends, pathogens are eliminated, and vision clears.
Qing Jie San (Clear and Resolve Powder) (Take in the morning)
Gu Jing Cao (Valerian Flower, 1 liang), Shi Jue Ming (Abalone Shell, 8 qian), Bai Ju Hua (White Chrysanthemum Flower, stem removed, wine-washed, 7 qian), Lu Dou Ke (Mung Bean Husk, 6 qian).
Grind into fine powder. Take 2 qian per dose. Take one large old persimmon, remove stem and core. Decoct in half a zhong of rice wash water until half dry. Eat the persimmon on an empty stomach, drinking the decoction along with it.
Bu Yuan San (Tonify Yuan Powder) (Take in the evening)
Ye Ming Sha (Bat Guano, washed clean, 1 liang, powdered), Zhen Ge Fen (True Clam Shell Powder, 5 qian, powdered).
Grind into fine powder. Take 2 qian per dose. Take a large piece of male pig liver, slice it open, apply medicine inside, cook in rice wash water. Eat as desired, chewing with the original juice. Take morning and evening. After seven days, take again.
Jia Wei Di Huang Wan (Modified Rehmannia Pill)
Huai Sheng Di (Rehmannia Root, sliced with bamboo knife, wine-washed, dried, 4 liang), Shan Yu Rou (Cornus Fruit, wine-washed, dried), Shan Yao (Dioscorea Rhizome), Bai Fu Ling (Poria, each 2 liang), Ze Xie (Alisma Rhizome), Mu Dan Pi (Moutan Cortex, each 1.5 liang), Ju Hua (Chrysanthemum Flower, stems/leaves removed), Mai Dong Rou (Ophiopogon Flesh, dried), Dang Gui (Angelica Sinensis Root, dried, each 1 liang), Wu Wei Zi (Schisandra Berry, 5 qian).
Grind into fine powder. Form pills with refined honey. Take on an empty stomach with light salt water. Adjust pill size for children. If adolescents have hyperactive fire, add Huang Bo (Phellodendron Bark) and Zhi Mu (Anemarrhena Rhizome), 5 qian each, processed with salt water. If eye opacities do not recede with previous medicines, eye drops may be used.
Tui Yun San (Remove Cloudiness Powder)
Hong Shan Hu (Red Coral), Zhen Zhu (Pearl), Chen Sha (Cinnabar), Peng Sha (Borax) (equal parts).
All used raw, ground extremely fine without sound. Apply twice daily.
Following residual toxins after smallpox often presents with cloud-like opacities blocking vision and external obstructions. If both eyes are clear externally without opacities but vision is difficult, it indicates congenital weakness and insufficiency of liver and kidney meridians, resulting in pale divine light and possibly dilated pupils. Eye drops and opacity-resolving medicines are unnecessary. Only tonifying root agents should be taken. When essence generates qi, and qi generates spirit, benefits extend beyond the eyes to prolong life.
Gu Ben Wan (Solidify Root Pill)
Shu Di Huang (Prepared Rehmannia Root), Sheng Di Huang (Raw Rehmannia Root), Tu Si Zi (Cuscuta Seed) (each 1 liang), Dang Gui (Angelica Sinensis Root), Wu Wei Zi (Schisandra Berry), Gou Qi (Goji Berry) (each 8 qian), Mai Men Dong (Ophiopogon Tuber, heart removed), Niu Xi (Achyranthes Root), Tian Men Dong (Asparagus Tuber) (each 7 qian), Fu Shen (Poria with Hostwood), Di Gu Pi (Lycium Bark), Yuan Zhi (Polygala Root) (each 5 qian).
All ingredients must be processed according to regulations, weighed accurately. Grind into fine powder. Form pills with refined honey, size of paulownia seeds. Take 20-30 pills on an empty stomach with light salt water. Take in the evening. Can be taken with tea or alcohol. Safe for long-term use.
Commentary: The preceding two discussions and formulas address cases where the eyeball is clear without external opacities. If the pupil appears pale, it is not an external obstruction but an internal qi barrier. The distinction between "qi" and "opacity" must be clear. Determine the primary treatment to avoid misdiagnosis and lifelong harm.